Provider Demographics
NPI:1750829339
Name:SEEPAUL, TIFFANY (BCBA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:SEEPAUL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:O'BRIEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:2408 VANDERVORT RD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5756
Mailing Address - Country:US
Mailing Address - Phone:727-514-5239
Mailing Address - Fax:813-358-1033
Practice Address - Street 1:2408 VANDERVORT RD
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-5756
Practice Address - Country:US
Practice Address - Phone:727-514-5239
Practice Address - Fax:813-358-1033
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-19-10389106E00000X
FL1-21-47031103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst